Healthy Hearts in Mediterranean Lands? Maybe Not

Jan. 13, 2011 -- For years, the Mediterranean diet, well-known for its heart-healthy effects, has evoked images of dining tables laden with fruits, vegetables, whole grains, red wine, and a splash of olive oil -- with those who follow the diet protected against heart attacks and other cardiovascular ailments.

However, a new study that looked at more than 2,000 urban Spanish adults challenges the thinking that people in Mediterranean countries all enjoy healthy diets and lifestyles.

Cardiovascular diseases are the main cause of death in Spain, accounting for 33% of all deaths. In the new study, researchers looked at residents of Malaga City on the southern coast, finding they had a prevalence of cardiovascular risk factors similar to those found in the U.S. and the U.K.

The problem is not the diet itself, but that some residents can't afford the foods that make it up, says researcher Rosa Bernal Lopez, PhD, of the Virgen de la Victoria Hospital in Malaga. ''The paradox is that traditional foods of the Mediterranean diet (olive oil, fruits, vegetables, legumes, fish) are more expensive than junk or fast food, so the social classes with lower purchasing power have more difficulty following the traditional Mediterranean diet."

''This study is showing us the prevalence of risk factors [for heart disease] is very similar to other countries," says Martha Daviglus, MD, PhD, professor of preventive medicine and medicine at the Northwestern University Feinberg School of Medicine and an American Heart Association spokeswoman.

She reviewed the study findings for WebMD.

The findings are no reason to abandon the Mediterranean diet, Daviglus says, if it's followed correctly. "A modified Mediterranean diet is a great idea to follow," she says.

The study appears in The International Journal of Clinical Practice.

In an editorial accompanying the research, Anthony Wierzbicki, MD, PhD, a consultant in metabolic medicine and chemical pathology at Guy's & St. Thomas' Hospitals in London, points out that the original research on the Mediterranean diet was done 40 years ago on rural populations and that lifestyles have changed dramatically since then, with more fast-food consumption and less manual work.